Failure of the surgery to control the cancer when the surgeon intends it to do so. If the PSA rises after the surgery then the surgery failed in its mission to control the cancer. Just as if after radiotherapy the PSA rose to a level that would indicate the radiotherapy failed. In each case it would have been the objective of the practitioner to control or cure the cancer with their treatment.
If, however, it is known at the diagnosis that a mono-therapy would not be successful but surgery or radiotherapy is advised to de-bulk the cancer, then we wouldn’t consider the treatment as failed when PSA continued to progress. In these cases the objective of treatment is to achieve a remission, hopefully long and durable. In advanced stage diagnosis, most know that no treatment will result in total control or cure. But the treatments are meant to prolong life and reduce the side effects of the cancer advances.
Hal, in the case you are referencing, the OP recently stated that the urologist stated they are now treating locally advanced disease. While I think it is early to so state as they don’t even have a 3 month PSA test, it may be that the urologist and surgeon know, but have not yet explained, that the surgery was unsuccessful in its intent to control and cure the PCa.
PSA 59 on 8-26-2010 age 60. Biopsy 9-8-2010 12/12 positive, 20-80% involved, PNI in 3 cores, G 3+3,3+4,and 4+3=G7, T2b.
Eligard and Jalyn started on 10-7-2010. IMRT to prostate and lymph nodes started on 11-8-2010, HDR Brachytherapy December 6 and 13, 2010.
PSA < .1 since February 2011. Located in Cumming Georgia north of Atlanta
Post Edited (JNF) : 8/8/2019 4:14:36 PM (GMT-6)